| NPI | 1952620056 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NJ 28ri01829800) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: PA rp034506t) |
| Enumeration Date | 2010-05-28 |
| Last Update Date | 2010-05-28 |